Gliadel

Gliadel is a brand name for carmustine implant, a type of chemotherapy medication used in the treatment of brain tumors. It is specifically indicated for patients who have undergone surgical resection of a malignant glioma, such as glioblastoma multiforme, and are at high risk of recurrence. Gliadel implants are biodegradable wafers that are placed directly into the cavity created by the surgical removal of the tumor. Each wafer contains carmustine, an alkylating agent that works by damaging the DNA of cancer cells, preventing them from dividing and growing.

The implantation of Gliadel occurs during surgery. After the tumor is removed, the surgeon places the wafers into the tumor bed. The wafers then slowly release carmustine over a period of two to three weeks as they gradually dissolve. This localized delivery of chemotherapy allows for a high concentration of the drug to be delivered directly to the affected area while minimizing systemic exposure and its associated side effects. The biodegradable nature of the wafers means they do not require removal.

Gliadel is typically used as an adjunct to other treatments for malignant gliomas. While it has shown efficacy in improving survival rates for certain patients, it is not a cure for brain cancer. The decision to use Gliadel is made by a neuro-oncologist based on factors such as the type and stage of the tumor, the patient's overall health, and the potential benefits versus risks. Like all chemotherapy, carmustine can have side effects, though the localized delivery of Gliadel may reduce the incidence and severity of some of these compared to intravenous administration.